Wenger and colleagues measured how many patients with acetabular labral tears had a structural hip abnormality visible on plain radiographs.
Mayo Clinic review of 31 patients with labral tears confirmed by arthrography or surgery (1996 to 2002), mean age 39.9, with classic dysplasia, advanced arthritis and prior osteotomy excluded.
Key Findings
27 of 31 patients (87%) had at least one structural abnormality on plain radiographs and 11 (35%) had more than one. Only 4 (13%) had none.
The commonest abnormalities were coxa valga (16 of 31, 52%), small anterior head‑neck offset (11 of 27, 41%) and acetabular retroversion (10 of 28, 36%).
Because classic dysplasia was excluded by angle cutoffs, no hip had an abnormal Wiberg angle. Only 2 had a mildly abnormal Tönnis angle and 2 were incongruent.
Of the 22 tears imaged by arthrography, 21 (95%) involved the anterosuperior labrum and 68% involved more than one quadrant.
The only tear sparing the anterosuperior labrum was an isolated posteroinferior tear in a hip with no structural abnormality, thought clinically to follow recent trauma.
The authors read the anterosuperior predominance as supporting anterior impingement and anterior acetabular deficiency as the main mechanisms. There was no matched control group without labral tears.
Board pearl
The authors suggest that labral debridement may only partly help if bony abnormality persists, giving incomplete or temporary relief because the underlying condition remains. The study measured no treatment outcomes.
Authors' conclusion
To our knowledge, this is the first study to document that the majority of patients with labral tears have a structural hip abnormality detectable with conventional radiographs. Familiarity with these structural abnormalities is important for early detection and accurate diagnosis, and may impact optimal treatment planning and prognosis.
Wenger and colleagues measured how many patients with acetabular labral tears had a structural hip abnormality visible on plain radiographs.
Mayo Clinic review of 31 patients with labral tears confirmed by arthrography or surgery (1996 to 2002), mean age 39.9, with classic dysplasia, advanced arthritis and prior osteotomy excluded.
Key Findings
27 of 31 patients (87%) had at least one structural abnormality on plain radiographs and 11 (35%) had more than one. Only 4 (13%) had none.
The commonest abnormalities were coxa valga (16 of 31, 52%), small anterior head‑neck offset (11 of 27, 41%) and acetabular retroversion (10 of 28, 36%).
Because classic dysplasia was excluded by angle cutoffs, no hip had an abnormal Wiberg angle. Only 2 had a mildly abnormal Tönnis angle and 2 were incongruent.
Of the 22 tears imaged by arthrography, 21 (95%) involved the anterosuperior labrum and 68% involved more than one quadrant.
The only tear sparing the anterosuperior labrum was an isolated posteroinferior tear in a hip with no structural abnormality, thought clinically to follow recent trauma.
The authors read the anterosuperior predominance as supporting anterior impingement and anterior acetabular deficiency as the main mechanisms. There was no matched control group without labral tears.
Board pearl
The authors suggest that labral debridement may only partly help if bony abnormality persists, giving incomplete or temporary relief because the underlying condition remains. The study measured no treatment outcomes.
Authors' conclusion
To our knowledge, this is the first study to document that the majority of patients with labral tears have a structural hip abnormality detectable with conventional radiographs. Familiarity with these structural abnormalities is important for early detection and accurate diagnosis, and may impact optimal treatment planning and prognosis.